Overview

• House Energy and Commerce Committee held a hearing to address pharmacy benefit managers' (PBMs) practices and their impact on prescription drug prices.
• PBMs, which negotiate drug rebates and manage insurance pricing, control 80% of U.S. prescriptions through three major companies, raising concerns about market concentration and anti-competitive practices.
• Proposed reforms include banning spread pricing, mandating full rebate pass-through to consumers, and requiring divestment from vertically integrated pharmacy businesses.
• Critics argue that PBMs and pharmaceutical companies both contribute to high drug costs, with PBMs accused of retaining savings and drugmakers blamed for setting high list prices.
• Legislative efforts to reform PBMs have stalled in Congress, with bipartisan support tempered by lobbying influence and broader political disagreements over healthcare policies.